A client in an urgent care clinic is complaining of heart palpitations, fatigue, and shortness of breath. A 12-lead electrocardiogram (ECG) shows no discernable P-waves, and an irregular ventricular rate. The nurse should understand that this finding represents which of the following conditions?

Atrial flutter

Atrial fibrillation

Unstable angina

Premature atrial contractions (PACS)

Answer and Explanation

The Correct Answer is B

A. Atrial flutter typically presents with a regular atrial rate (usually around 250-350 beats per minute) and a characteristic "sawtooth" pattern of flutter waves (F-waves) on the ECG. This condition would not present with irregular ventricular rates and is less likely based on the ECG findings described.

B.   Atrial fibrillation is identified by an irregularly irregular rhythm and the absence of P-waves on the ECG, which is replaced by erratic activity.
C.   Unstable angina presents with chest pain or discomfort due to reduced blood flow to the heart muscles, usually related to atherosclerotic plaque rupture or erosion. It does not cause the ECG findings described (absence of P-waves and irregular ventricular rate).
D.   PACs are early atrial depolarizations that can cause palpitations but do not typically result in the absence of P-waves or irregular ventricular rates as described in the scenario.

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Correct Answer is B

Explanation

A. Carbidopa itself does not cross the blood-brain barrier. Its primary role in Sinemet is to inhibit the peripheral breakdown of levodopa (the precursor of dopamine) into dopamine before it reaches the brain.
B. It is true that it may take a few weeks to see the full effects of this medication, as the body needs time to adjust to it.
C. Parkinson's disease is progressive, and as the disease advances, the dosage and frequency of levodopa with carbidopa may need to be adjusted to maintain symptom control. Over time, higher doses or additional medications may be required to manage symptoms effectively.
D. Levodopa does not protect Carbidopa; rather, Carbidopa protects Levodopa from early conversion to dopamine outside the brain, which would make it less effective.

A. Plasmapheresis B. Riluzole C. Anticholinesterase agents D. Acyclovir

Correct Answer is A

Explanation

A. Plasmapheresis, also known as plasma exchange, is a treatment where blood plasma containing harmful antibodies is removed from the blood and replaced with donor plasma or albumin. This procedure is effective in reducing the severity and duration of symptoms in GBS by removing the antibodies that attack the peripheral nerves. Plasmapheresis is typically recommended within the first 2 weeks of symptom onset to maximize its benefits.
B. Riluzole is a medication that modulates glutamate neurotransmission and is primarily used in the treatment of amyotrophic lateral sclerosis (ALS). While some studies have explored its potential use in GBS, its efficacy in GBS treatment remains uncertain and it is not considered a standard treatment.
C. Anticholinesterase agents, such as pyridostigmine, are used in conditions characterized by neuromuscular junction dysfunction, such as myasthenia gravis. However, in GBS, where the primary pathology is the demyelination of peripheral nerves rather than neuromuscular junction dysfunction, anticholinesterase agents are not effective and can potentially worsen symptoms.
D. Acyclovir is an antiviral medication primarily used to treat infections caused by herpesviruses, including herpes simplex virus (HSV) and varicella-zoster virus (VZV). It has no role in the treatment of GBS because GBS is not caused by viral infections.

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A client in an urgent care clinic is complaining of heart palpitations, fatigue, and shortness of breath. A 12-lead electrocardiogram (ECG) shows no discernable P-waves, and an irregular ventricular rate. The nurse should understand that this finding represents which of the following conditions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with Parkinson's disease is started on Levodopa with Carbidopa (Sinemet). What should the nurse include in the patient teaching?

Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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